The loss of estrogen and testosterone following menopause can lead to changes in a woman’s sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and foreplay — which can result in decreased interest in sex.
In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to become dry and cause painful intercourse.
A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:
Bladder control problems (incontinence)
Depression or anxiety
Some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.
During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy or in women who are prone to recurrent urinary tract infections.
Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.
A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Estrogen replacement may help raise the sex drive after menopause which is associated with a decrease in estrogen. Estrogen can also make intercourse less painful by treating vaginal dryness.
Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.
Bottom Line: Sexual desire and enjoyment from sexual intimacy can be preserved after menopause. It may dry the vaginal lining but it doesn’t have to dry up the desire to be sexually intimate with your partner.